| Plaza Del Sol Family Health Center | |
|
3716 108th St Corona NY 11368-2025 | |
| (718) 651-4000 | |
| (718) 991-4516 |
| Full Name | Plaza Del Sol Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3716 108th St, Corona, New York |
| Authorized Official Name and Position | Samuel Deleon (CMO/VP MEDICAL AFFAIRS) |
| Authorized Official Contact | 7185892440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plaza Del Sol Family Health Center 3716 108th St Corona NY 11368-2025 Ph: (718) 651-4000 | Plaza Del Sol Family Health Center 3716 108th St Corona NY 11368-2025 Ph: (718) 651-4000 |
| NPI Number | 1710125141 |
|---|---|
| Provider Enumeration Date | 01/22/2009 |
| Last Update Date | 02/28/2011 |
| Medicare PECOS PAC ID | 3173517281 |
|---|---|
| Medicare Enrollment ID | O20090313000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710125141 | NPI | - | NPPES |
| 00244977 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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